Portrait of a Buddhist Chaplain: Holly Hisamoto Leans Into Practice

DHARMA AND THE MODERN WORLD

January-March 2015

Holly Hisamoto

By Donna Lynn Brown

In September 2014, Donna Lynn Brown, a student at Maitripa College in Portland, Oregon, US, interviewed Holly Hisamoto, who recently completed a year-long residency at Legacy Emanuel Medical Center in Portland, about life as a Buddhist hospital chaplain. This is what she found out.

Who is Holly Hisamoto?

Holly is a chaplain at Legacy Emanuel Medical Center, a hospital in Portland, Oregon. She has a BA in Religious Studies from Naropa University and a Master of Divinity in Buddhist Chaplaincy from University of the West in California. She has worked in hospice, early childhood education and community organizing. Holly interned as a chaplain at Children’s Hospital Los Angeles and completed a year-long residency at Legacy Emanuel in September 2014. She is now on staff there as a chaplain associate.

Like most modern chaplains, her job is interfaith, and her hospital role is not specifically Buddhist.

Why did she become a chaplain?

Holly wanted to use Buddhism to help others via a career in human services. That was how she saw herself living her faith and practice. At one point, while training as a hospital ethicist, she spent some time volunteering in hospices. Watching chaplains at work there, she found their role compelling. That was when she decided to pursue a career in chaplaincy.

Is she a board certified chaplain?

Holly plans to apply for certification from the American Association of Professional Chaplains in a year or so, when she will have accumulated the required 2,000 hours of on-the-job experience. In addition to having 2,000 clinical hours, to obtain certification she will have to submit essays on her theoretical and theological methods, be ordained or commissioned by a faith group, document her competencies, and be evaluated by a panel of certified chaplains.

What does she do at work?

Although hospital chaplains offer prayers or rituals if requested, their role has changed significantly as the world has become more secular. Holly said that she and her colleagues are there to “hold the space of the patient’s inner life” in a health care environment where other professionals are more body- and task-oriented. Chaplains try to ensure that patients’ entire experience is respected – that they are perceived, and can perceive themselves, as whole people, not just bodies in for repair. That means, for example, giving space for patients to talk about what matters to them and providing the emotional solidarity of “I see you. I know this is hard,” when people are rocked by intense events. Other roles include de-escalating conflict, being a companion, advocating for patients regarding aspects of their experience missed by others and helping patients navigate the health care system. Holly also checks in with staff, and gives time and attention to their needs too.

One fact of hospital life is the fast pace. Holly seldom has time to get to know a patient. While she sometimes has the opportunity to unpack a patient’s spiritual perspectives, crises are all too frequent. When they occur, she has to be “the less anxious presence,” bringing sanity to the scene and embodying a non-panicked mode of being. At that time, the patient usually has one immediate issue, such as fear or hopelessness. That issue is loud, and it is what Holly must address. By doing so, she meets the patient’s most pressing need.

How does the job relate to Dharma practice?

“This work wouldn’t be possible without a strong practice life. I think that’s true for a lot of chaplains,” Holly said. Chaplains get called in when there is a death, disaster, potential lawsuit, or other significant issue, just like emergency personnel or police. The content of the experience can be intense: fear, blood, violence, pain, death. She intentionally works with her life in the hospital as practice, applying her Buddhist training both “on the cushion” and on the job. By mindfully framing situations, she can experience them as “another thing arising” rather than a dramatic or upsetting story. And by taking notice of the full range of her feelings, she finds that they include positive ones like being glad to have connected with the people involved. Such methods help her avoid trauma or burn-out.

As for “religion” in her interactions, she said that the level of overt religion among patients varies by location. In Portland, patients rarely frame their experience in religious terms, but in Los Angeles, many do. “There’s not much Buddhism,” she added, “because there are so few Buddhists.” But for her, the work itself is a practice. And that is vital to being good at her job. Hospitals hire religious people now not so they can talk to patients about religion, but because they have the mental and spiritual resources to deal with what is happening to patients and staff – and go there with them. That involves both opening their hearts, and keeping themselves safe and healthy in the short and long term. You are a chaplain, said Holly, “so that you can be a certain kind of person for others.”

Photo by Dreamstime

What challenges has she faced?

To be a chaplain means being completely present for others, on their schedules, and responding to situations that may be new, unexpected, or uncomfortable. Holly has learned to just go with what happens: she found that her anxiety as she was learning the job was always related to her expectations, which never failed to differ from reality. This taught her to relax. “There is a confidence that comes with knowledge and experience,” she emphasized. An introvert, she tries to take time to regroup between patients, retreating to her office – which she calls “the cave” – a kind of self-regulation her schedule usually allows. And she also, sometimes, has leisurely discussions with patients – fortunately, the job is not all crises.

One hazard of chaplaincy for her initially came from the intensity of life at the hospital, where everything has great significance – what she says and how she says it and how long she stays with people. The contrast with regular life was jarring, and for a time, made activities outside of work feel frivolous or shallow. Soon she realized that her ordinary life could not be allowed to matter less than her work. Part of navigating the different modes of being was unlearning the thought that “what is meaningful is emotionally intense,” and rediscovering that play, enjoyment, and daily pastimes had their own meaning and value.

What are the boundaries of her job?

The lines between chaplaincy, counseling and social work are unclear to many people. For example, Holly sometimes needs to educate hospital staff who think that chaplains only do rituals and prayers. She talks to them about chaplaincy’s role in providing companionship, as well as helping people, religious or not, to process values, purpose and meaning. Staff and others sometimes question the boundaries between this role and that of social workers or psychologists. The former organize community resources, while the latter mainly work with the mentally ill. In some hospitals, roles are less distinct, but guidelines on “professional scope of practice” help to set boundaries. Holly emphasized mindfulness and attention to ethics in negotiating the professional terrain.

What supports does she have?

During her period of residency, which recently finished, the support Holly received was significant and ongoing. She worked as a chaplain part of the day and spent part of the day preparing reflections and discussing her experiences with peers and mentors. There was a lot of processing, personal digging, support and feedback. It was an intense learning experience. As a staff chaplain, she now has less formal support and more freedom. Mentorship is available to her through the Association of Professional Chaplains. To process a difficult day, she might call someone, or talk to someone from her Dharma community or her partner. Chaplains also rely on each other, and Holly often talks to her colleagues. Since the people who do this kind of work are deeply caring and relational, she feels that any chaplain she reached out to would “show up” for her. Hence, she never has a sense of being unsupported.

Does she like being a chaplain?

Holly does not view the job as being about “liking” her high-stress environment. It doesn’t matter a great deal to her whether she likes it. For example, on sleeping overnight in the “on call room,” she said: “It was a vivid understanding of what it means to respond to the cries of the world – you get out of bed at 2 a.m. I am making myself available, and I always aspire to be able to do that. This is my opportunity to see what that’s actually like. … It’s uncomfortable to get up at two in the morning and go into an emergency department and experience stress, but I get to really lean into these vows that I made.”

On whether the job makes her happy, Holly’s response was thoughtful. “It would not be true to say that I find joy in these really challenging experiences,” she said, “but I find joy in the relationships that are fostered in the midst of these challenging experiences. There is just so much beauty in the work. Especially in situations of birth and death. People inhabit those momentous occasions so fully. … They are very present, with everything that that means. Often, crises can provoke negative emotions and people lose touch with their own wisdom. In that context, it is very meaningful to assist patients to identify and use their own spiritual resources – sources of wisdom, guidance and meaning – to help themselves. And sometimes people are able to find forgiveness, or love, or what it is they want to say, or how they want to ritualize a transition. The best of people’s relationships come out. It’s such an honor to be there. And so humbling. I’m a complete stranger and people invite me into the midst of these life-changing experiences. Who am I to be part of this? It’s incredible.”

How would she sum up the job?

Holly expressed awe that chaplains even exist – that hospitals keep someone on staff to be a companion in times of trouble. And she feels honored that people are willing to receive that. Recently, she said, a woman going into major surgery had a panic attack in the waiting area. Holly was called in. “How amazing,” she said, “that hospitals have someone there just to hold this person’s hand, to be present, and to deeply care.”

You can see from your own life experiences how the environment can affect you. When you’re among peaceful, generous, happy people, you’re inclined to feel happy and peaceful yourself. When you’re among angry, aggressive people, you tend to become like them. The human mind is like a mirror. Therefore, it is very important to be conscious of your surroundings and how they affect your mind.